Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Revitalize Spine & Sports Care PLLC

Organization Pain Medicine (Physical Medicine & Rehabilitation) Physician · NPI 1407430317

Revitalize Spine & Sports Care PLLC is a Pain Medicine (Physical Medicine & Rehabilitation) Physician in Kennewick, Washington. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4309 W 27th Pl Ste 202
Kennewick, WA 99338-2908
Phone: (509) 591-4966
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pain Medicine (Physical Medicine & Rehabilitation) Physician (primary) Taxonomy 2081P2900X

Record details

NPI number1407430317
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official John Groner — Owner / Md · (509) 591-4966
NPI enumeratedMay 6, 2021
Last updated in NPPESMay 6, 2021
Certification dateMay 6, 2021
Mailing address4309 W 27th Pl Ste 202, Kennewick, WA 99338-2908

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